Conditions - Amniotic Fluid Embolism

Question 1

Define amniotic fluid embolism

Answer 1

Rare complication of pregnancy where foetal cells/amniotic fluid enters the mother’s bloodstream and stimulates a reaction resulting in classical signs/symptoms. (chills, shivering, sweating, cyanosis, hypotension, tachycardia, arrhythmia, among others)

Question 2

What is the aetiology of amniotic fluid embolism?

Answer 2

Clear cause unknown

Question 3

What are the risk factors for amniotic fluid embolism?

Answer 3

Maternal age

Induction of labour

Question 4

What is the epidemiology of amniotic fluid embolism?

Answer 4

2 in 100,000 in the UK

Mainly occurs in labour but can occur during c-section and after delivery in immediate postpartum

Question 5

What are the presenting symptoms of amniotic fluid embolism?

Answer 5

Chills
Shivering
Sweating 
Anxiety
Coughing

Question 6

What are the signs on physical exam of amniotic fluid embolism?

Answer 6

Cyanosis
Hypotension
Bronchospasms
Tachycardia
Arrhythmia
Myocardial infarction

Question 7

What investigations should you do, if any, and what results would you expect?

Answer 7

Clinical diagnosis of exclusion

Question 8

Amniotic fluid embolism management plan?

Answer 8

o Critical care unit by MDT, management predominantly supportive
In event of peri-arrest (like heart attack) then do a category 1 c-section (aiming to save baby and help mum’s resus)

Question 9

What is the prognosis for patients with amniotic fluid embolism?

Answer 9

10% survival (30% dying in 1st hr)